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What is silent reflux in babies and young children?

Reflux, posseting or bringing food back up is common in babies and young children, but when food brought up doesn’t actually come out of the mouth, this is called silent reflux.

Silent reflux, also known as laryngopharyngeal reflux or LPR, can be harder to diagnose because there are no outward symptoms to explain why a baby is distressed or uncomfortable.

What happens with silent reflux?

Silent reflux is common in infants because their stomach sphincter is undeveloped, they have a shorter oesophagus and they lie down a lot of the time. The cause in adults is not known.

The sphincter is a ring of muscle at either end of the stomach. It works as a valve to keep swallowed food and drink in the stomach. With LPR, the upper sphincter doesn’t work correctly, allowing stomach acid to reflux up into the back of the throat, voice box or nasal airway.

Infants may swallow the stomach content again.

The gastric acid can cause inflammation and discomfort and can lead to a condition called oesophagitis.

One possible symptom of silent reflux is a long-term cough.

Treatment for silent reflux

Seek medical advice from a health visitor or GP if you are concerned about a baby having silent reflux. The condition may be helped with home care changes that are also recommended for reflux or posseting. In some cases, medication or an operation may be recommended.

Tips to help reduce reflux in babies include:

  • Regular burping during feeds.
  • Don't overfeed a baby. Try smaller feeds more often.
  • For bottle feeding, make sure the hole in teats is not too big allowing too fast a flow of milk.
  • After feeding, hold the baby upright for some time.
  • Consider raising a baby's head while sleeping. Safe ways to do this include putting books under the head end of a cot or crib, or putting a pillow under the mattress. Don't put pillows in the cot itself.
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on January 16, 2017

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